A comparison of health-related quality of life (HRQoL) across four systemic autoimmune rheumatic diseases (SARDs).

Julia Greenfield,Marie Hudson,Christian A Pineau,Paul R Fortin,Evelyne Vinet,Mianbo Wang,Vivian Bykerk,Murray Baron,Sasha Bernatsky,Mahmoud Abu-Shakra

doi:10.1371/journal.pone.0189840

Abstract

ObjectivesTo compare physical and mental health-related quality of life (HRQoL) across four systemic autoimmune rheumatic diseases (SARD).MethodsIncident subjects enrolled in four SARD cohorts, namely systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA) and idiopathic inflammatory myopathies (IIM) were studied. The outcomes of interest were baseline Short Form Health Survey physical (PCS) and mental (MCS) component summary scores. Multivariate analysis was conducted to determine whether PCS and MCS scores differed across SARD type.ResultsThe study included 118 SLE (93% women, mean age 36 years), 108 SSc (79% women, mean age 55), 64 RA (63% women, mean age 58) and 25 IIM (68% women, mean age 49) subjects. Mean PCS scores were 38.9 ± 12.2 in SLE, 37.1 ± 13.3 in RA, 35.0 ± 13.6 in SSc and 28.0 ± 15.4 in IIM. Mean MCS scores were 45.0 ± 13.3 in RA, 44.4 ± 14.7 in SSc, 40.1 ± 14.3 in SLE and 33.6 ± 18.7 in IIM. SARD type was an independent predictor of HRQoL with, in some cases, the magnitude of the differences reaching one standard deviation (IIM worse PCS scores compared to SLE (β -12.23 [95% CI -18.11, -6.36; p<0.001]); IIM worse MCS scores compared to SSc (β -11.05 [95% CI -17.53, -4.58; p = 0.001]) and RA (β -11.72 [95% CI -18.62, -4.81; p = 0.001]).ConclusionsCross-SARD research provides a novel approach to gain greater understanding of commonalities and differences across rheumatic diseases. The differences observed warrant further research into correlates and trajectories over time.

Highlights

Systemic autoimmune rheumatic diseases (SARDs) are chronic, systemic inflammatory diseases characterized by autoimmunity
systemic autoimmune rheumatic diseases (SARD) type was an independent predictor of health-related quality of life (HRQoL) with, in some cases, the magnitude of the differences reaching one standard deviation (IIM worse Physical Component Summary (PCS) scores compared to systemic lupus erythematosus (SLE) (β -12.23 [95% CI -18.11, -6.36; p
The study subjects were members of one of four cohorts, the Canadian Scleroderma Research Group (CSRG) cohort, the Canadian Early Arthritis Cohort Study (CATCH) cohort followed at one site (Jewish General Hospital, Montreal, Canada), the McGill University Health Center Systemic Lupus Erythematosus Cohort (MUHC SLE cohort), and the Canadian Inflammatory Myopathy Study (CIMS) cohort

Summary

Introduction

Systemic autoimmune rheumatic diseases (SARDs) are chronic, systemic inflammatory diseases characterized by autoimmunity. SARDs are not common, but collectively they affect 5% of the population and are associated with high rates of disability, premature mortality, and significant societal costs[1, 2].Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), idiopathic inflammatory myopathies (IIM) and systemic sclerosis (SSc) are SARDs that share demographic, clinical, serological, immunological and genetic features. These diseases affect women more commonly than men; common clinical features include Raynaud’s phenomenon, sicca syndrome, inflammatory arthritis and lung disease; antinuclear antibodies [ANA] are common, T and B lymphocytes play a central role [3, 4] and a common type I interferon signature characterizes SARDs [5]; and SARD have common genetic defects eg. Research across diseases has the potential to identify mechanistic commonalities, as well as bring to light disease-specific abnormalities

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